Clinical and surgical-pathological staging in early non-small cell lung cancer

Abstract

Staging is of the utmost importance in the evaluation of a patient with non-small cell lung cancer (NSCLC) because it defines the actual extent of the disease. Accurate staging allows multidisciplinary oncology teams to plan the best surgical or medical treatment and to predict patient prognosis. Based on the recommendation of the International Association for the Study of Lung Cancer (IASLC), a tumor, node, and metastases (TNM) staging system is currently used for NSCLC. Clinical staging (c-TNM) is achieved via non-invasive modalities such as examination of case history, clinical assessment and radiological tests. Pathological staging (p-TNM) is based on histological examination of tissue specimens obtained with the aid of invasive techniques, either non-surgical or during the intervention. This review is a critical evaluation of the roles of current pre-operative staging modalities, both invasive and non-invasive. In particular, it focuses on new techniques and their role in providing accurate confirmation of patient TNM status. It also evaluates the surgical-pathological staging modalities used to obtain the true-pathological staging for NSCLC.

Evaluating clinical and radiomic features for predicting lung cancer recurrence pre- and post-tumor resection

“…An evaluation of feature importance in the PO model using SHAP highlighted post-surgical covariates, particularly tumor pathological features, as the primary contributors to the model's predictive ability, surpassing even those of radiomic features (Fig 4). Given that pathologic features offer insights into cancer aggressiveness and spread [23], it is unsurprising that these features were the most important for predicting recurrence.…”